Holy crap! The gist of the story to me, isn't so much that the formulation of Oxycontin will be changed, it's the REASON for the concern that has me gobsmacked. The formulation is being changed for a form that's far less easily crushed to be inhaled or injected by those addicted.

This is raising serious fears that across northern Ontario, a massive withdrawal crisis is about to unfold. Why? To my horror, it seems that the Nishnawbe Aski Nation or NN has Oxy addiction rates of up to 50%. This comprises kids as young as 9 to elders in their 80s. The Grand Chief further states that in some communities, the addiction rates are as high as %70-80!

He rightly states if there's no detox or replacement or treatment, things are going to become dire. This WOULD be a public health catastrophe as these communities are in the main, treated by nursing stations backed up by visiting doctors. Thousands of people potentially going into withdrawal in a short period of time. Some will replace oxy with other injectable drugs.

I can't help but wonder - where in hell did they get the Rx or wherewithall to buy black market oxy to that extent in the first place?

And where is all that black market Oxy coming from? What's a LOT of people to keep supplied. Ripping off a couple Rite-Aid pharmacies is not going to cover that.

It come from people who get legitimate prescriptions or those who get prescriptions from doctor shopping and pill mills.

In the first case they are very restricted and can only get a small amount at a time. They only get JUST ENOUGH to make it to the next prescription. Sick, can't go in to the pharmacy, whatever, and they don't have pills that day.
(Laws punish the people who need these drugs more than the people taking them illegally in my opinion.)

Since many of these people can't work they are on constrained budgets. Many pass taking their medication if they are doing reasonable well or are also medicating with alcohol or marijuana. They save these in case to tide them over if they are short of cash and can't get their prescription one month.

They then sell the extra pills for cash.

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“The price of freedom is the willingness to do sudden battle anywhere, any time and with utter recklessness.”
― Robert A. Heinlein, The Puppet Masters

Just as surely as Prohibition built organized crime in America, legal prohibition of a substance in demand creates the illegal market and drives the price up. A good chemist can make any compound. If there's a high enough demand, it will be manufactured. Period.

Wanna stop the illegal trade? Make everything legal. "Crime" is unnecessarily harming another (an action, not a thing), but that's all. Yeah, the stuff will be cheap and the stupid will soon eliminate themselves without needing to rob to support their habits. But it's their choice.

If they really want it, they'll buy it. And the worst nightmare of those supplying it illegally is to have it become legal. There's MONEY in illegal manufacture and sales.

Any and all prohibitions have only ever helped two groups: Criminals and Tyrants.

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America has ten times too many police, a hundred times too many citizens unwilling to take responsibility for their own defense and the consequences of their own actions, a thousand times too many politicians who wrongly believe they have the right to tell others how to live their lives, and a million times too many illegal aliens.

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Ontario just announced its delisting Oxy & the new substitute completely from it's Drug Benefit Program - unless as a prescribing physician you Rx it on what's known as Exceptional Access Program. Seniors & people on Ontario Disability as well as others who can get their drugs paid by the province have a fairly extemsive formulary of Rx meds available to them. They're generally not sexy or exciting - you'll rarely see the 'latest & best' version of anything but if your doc feels there's a legit need for something 'off list', it can be prescribed.

By putting Oxy's new formulation on the EAP, the province will force physicians to think twice about Rxing it. They can still Rx it withut this form but that means patients will have to pay for it. Those who somehow get on it to seel it on the black market will have to increase their price which means downline for the addict - prices go up.